


A Report on the Case History, Diagnosis, and Recovery of Harleen Quinzel

by Cra_Zwar101



Category: Batman - All Media Types, Batman: The Animated Series, DC Animated Universe, DC Cinematic Universe, DCU (Comics), Suicide Squad (2016)
Genre: Angst, Anti-Joker, Anti-Joker/Harlequin, Canon Compliant, Canon-Typical Violence, F/F, Gen, I just want to tag those in case mentions of them make you uncomfortable, I wrote this based on my own psychiatric analysis, Mental Health Issues, Mental Instability, No Dialogue, Past Abuse, Past Child Abuse, Schizophrenia, Written as though I am Harleen's Psychiatrist at Arkham, and mental illnesses, but the format is the regular format actual psychiatrists use, histrionic personality disorder, my diagnosis are different, only mentions though, psychiatry, this is about dealing with mental differences
Language: English
Status: Completed
Published: 2016-08-09
Updated: 2016-08-09
Packaged: 2018-08-07 16:13:13
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 857
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/7721392
Author URL: https://archiveofourown.org/users/Cra_Zwar101/pseuds/Cra_Zwar101
Summary: <blockquote class="userstuff">
              <p>A psychiatrist's report on the mental health history and treatment of Harley Quinn. Canon compliant with Poison Ivy and Harley's relationship, and treats the Joker/Harley ship the way it deserves: like an abusive, unhealthy and terrible relationship that should not be romanticized or apologized for.</p><p>Most compliant with the Batman Cartoons and the recent DC comics.</p>
            </blockquote>





	A Report on the Case History, Diagnosis, and Recovery of Harleen Quinzel

**Author's Note:**

> I had to write a paper for a psychology class about a fictional character. I ended up basing my paper on the report that a psychiatrist wrote about me. Despite having different diagnosis than Harley, I relate to her experiences of mental instability and it is nice to imagine that she would have reports written about her mental health in the way I did.  
> This is written from the perspective of a psychiatrist that attempts to help Harley with her disorders and criminality. I also got to include some nice anti-Joker content and some references to Harley/Pamela and how their relationship is much healthier, and how Pamela (Poison Ivy) helps Harley avoid falling back under the control of the Joker.  
> Now, I am not an actual psychiatrist, nor do I have schizophrenia. If there is anything in this fic that someone with these diagnoses finds offensive or inaccurate, I would be happy to change the work to be less insensitive, and I would even be willing to take the work down. But please, be kind with your comments and I will be better able to learn.

Patient: Harleen Quinzel

Case History: Dr. Harleen Quinzel was a patient of mine during my time at Arkham Asylum for the Criminally Insane. I had the opportunity to speak with her only a few times, but she was surprisingly willing to participate in therapy. Actually a psychiatrist herself, when not experiencing a sense of altered reality, she shows incredible intelligence and a more balanced world-view than most of those kept in the asylum. Through the limited time spent in session, I have determined it is likely that the parental abuse she suffered as a child made her vulnerable to manipulation by the criminal known as “the Joker”. Through her connection with him, Dr. Quinzel became embroiled in his dangerous criminal activities, putting her in a position where her delusions allowed her to murder and assault people she otherwise wouldn’t. In the aftermath of one of these events, Dr. Quinzel was apprehended by the police and sent to Arkham, as her particular criminal behavior strongly suggested mental health instability. The Joker was not apprehended at this time. I was not able to continue therapy for very long, as Dr. Quinzel escaped imprisonment a few months after her arrival at the asylum. It is likely she is back in company with “the Joker”. This is in no way beneficial to her journey towards being a well-adjusted and healthy individual.  
Diagnosis: Though her criminal and violent behavior seems a result of a disregard for others, I have determined that Dr. Quinzel actually cares very deeply for others, as shown by her concern for children and her obvious current distress at her part in multiple violent murders. I theorize that Dr. Quinzel instead struggles with very intense schizophrenia, and the hallucinations and delusions that she experiences morph her perception of reality to a point that she does not understand, in the moment, the consequences of her actions. In our time together, Dr. Quinzel has divulged that she does hear voices, and that they often encourage her to commit actions she would otherwise not consider.  
Additionally, Dr. Quinzel’s dramatic and otherwise extremely inappropriate and lewd behavior, especially the loud theatrics that often accompany her criminal acts, seem to be an attempt to gain the attention of those surrounding her, whether that attention be negative or positive. Her difficulty in separating herself from the obviously dangerous and abusive “Joker” (as the man calls himself) stems from her dependency on his attentions. The mans’ abusive and extremely inconsistent treatment of Dr. Quinzel during their time together leaves her vulnerable to his unethical and criminal suggestions. These are all symptoms enough to warrant a diagnosis of histrionic personality disorder.  
Etiology: Both Dr. Quinzel’s personality disorder and schizophrenia are likely directly linked to the trauma she suffered as a child, and perhaps a genetic cause as well. 

DSM Multi-Axial:  
Axis I- Schizophrenia  
Axis II-Histrionic Personality Disorder  
Axis III- None  
Axis IV- Abuse by the “Joker”, past trauma, criminality  
Axis V- 20-30; commits crimes e.g. violence against others, major theft, extremely inappropriate behavior limiting social ability, majorly influenced by delusions and hallucinations

Treatment: In order for Dr. Quinzel to reach a point where she can function well in society, I am suggesting intensive cognitive-behavioral therapy to help deal with the childhood trauma and guilt over actions made while affected by delusions, and psychotherapy counseling to help her cope with and decrease the symptoms of histrionic personality disorder. Medication such as anti-psychotics to diminish the power of her hallucinations and delusions, and potential anti-depressants or anti-anxiety medications to help decrease negative emotional side effects of HPD and lower vulnerability to and dependence on potential abusers would be beneficial. Additionally, immediate and total separation from the corrupting and abusive influence of “the Joker” is essential for Dr. Quinzel’s treatment to make any progress at all. It is hard to say whether Dr. Quinzel will be able to start these treatments while at large under her alias as “The Harlequin”, but I am confident that with time and persistence, these recommendations would be successful in helping her to gain control and mental stability.  
5 Year Follow-Up: This time I was fortunate to work with Dr. Quinzel under happier circumstances. No longer a consistently present “supervillian”, Harleen has recently begun seriously pursuing therapy. For a few years after my first attempt at therapy with her, Harleen still pursued a life of violent crime under the suggestions of “the Joker”. However, when the Joker was arrested and imprisoned, Harleen was able to start making headway on the road to adjustment. Away from the negative influence of the “supervillian”, and with the encouragement of her new partner, Dr. Quinzel is now regularly attending therapy appointments and consistently taking anti-psychotics. Ms. Pamela Isley, her current partner, is very aware of Harleen's past trauma and mental health issues, and has played a large role in Dr. Quinzel's current separation and recovery from the abusive experience she had while under the influence of the Joker. Though she has admitted to still committing some small-scale crimes, Harleen has not violently assaulted anyone for a while, and I am confident she is on the path to recovery.


End file.
